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Home My WebLink About2003-P06681 (Re-roof) c IT PERMIT C Y OF ORONO permit Number: 2750 Kelley Parkway- PO Box 66 P06681 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 8�2i�2oo3 SITE ADDRESS: 2380 Abingdon Way Long Lake,MN 55356 PID: 03-117-23-23-0020 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: B��g Permit Type: Minor Alterations Permit Sub-type(s): B��g-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 223.25 Valuation• $ 13,000.00 State Surcharge Fee: $ 7.00 TOTAL FEE: $ 230.25 APPLICANT: Westurn Roofing OWNER• John&Carol Busacker 9700 13th Ave � 2380 Abingdon Way Plymouth,MN 55441 Long Lake,MN 55356 THE UNDERSIGNED HEREBY REQUESTS PIIZMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MIlVNESOTA BUII.DING CODE REQUIREMII�ITS. ��C�� /G�� APPLICAd PERMTTEESIGNATURE ISSUEDBYSIGNATURE Copies:1-File(Si�nituYes ReAuired),1-Avplicant 1-Monthlv Reports, 1-A�essinQ,1-Finance Page 1 . �� . . Total Fee: $ �3d. �-� Date Received:_ ��/-�"� Entered By: �� Permit#: �p�� CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT All information must be submitted in full before plan review will be started. {please print all information) -------------__---------------------------_--_-------------------- � - - -----____________—_ THE APPLICANT IS: (circle one) OWNER OR TRACTOR JOB SITE ADDRESS: a 3 gc� lj i' p� ZIP: ,s S �S� NAME OF OWNER: �ol�h �r.`,5�,c �.r. PHONE: (�effie)G�-- 839- g8�/y (work) 9 5.Z- y 96- '9� MAILING ADDRESS: �� CITY: �-G . ZIP: SS 3 S'� CONTRACTOR: l�5 r �� PHONE: �6_�Sy��d3cx/ CONTACT PERSON: /�ry,-L BILE/PAGER:��.-a 8a r�fa�-S� MAILING ADDRESS: 9'�0� � �'`'.A�- .� CITY: ��s�n�22�� ZIP: SSf�l� STATE LICENSE: # �o/SS.S�'6 ARCHITECT/ENGINEER: PHONE: MAILING ADDItESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move RemodeUAlteration Land Alteration PROPOSED WORK(describe in detai�: %- G� • �Uo� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIlVIATED CONSTRUCTION VALUATION(excluding lan�: $ 1�� I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: ��i� DATE: g' ��'"0.3 . NOTE! Parade of Homes events require separate permit approval by Police Department cr,�e� City Council 60 days prior to the event. Non permitted events will not be allowed • � '• • Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Iaformation req�red to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng State agency,political svbdivision,or statewide system; (b)whether he may refuse oY is legally requiced to supply the requested data;(c)any l�own consequence azising from his supplying or refusing to supply private or confideatial data;and(d)the identity of other persons or entities authorized by state or federal law to receive the daca. This requirement shall not apply when an individual is asked to supply investigaave data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of revenue mav alace the nodce required under this subdivisian in the individual income tax or nroaertv tax refund insnucdons instead of on those focros. Subd.3. Access to data by iadividual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her it is class�ed as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and;if he desires,shall be informed of the content and meaning of that dara. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for siz months thereafter unless a dispute or action pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. The rrsponsible authoriry shall provide copies of the private or public data npon request by the individual subject of the data. The responsi'ble authority may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authority shall comply ima►ediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Suadays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise rhis right,an individual shall notify in writing che responsfble authority describing che nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct tfie data faund to be inaccurate or incomplete and attempt to norify past recipienu of inaccurate or incomplete data,including recipients named by the individual;or(b)notify�e individuat that he believes the data to be cocrec� Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinaaon of the responsible authority may be appealed pursuant to the pro\ns of the admiaistrarive procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You aze notified that: 1, The information you fumish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. F� Middle � Address . Ciry State Zip Phone I understand my rights as stated above. . � — Signature •